How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $112.20 Median $3,235.94 Typical High $7,762.47 | Facility | None | $112.20 | $3,235.94 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $147.91 Typical High $245.47 | Professional | None | $64.57 | $147.91 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $158.49 | Professional | None | $79.43 | $107.15 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $177.83 Typical High $363.08 | Professional | None | $77.62 | $177.83 | $363.08 |
Denver HMP Setting Facility Modifier None Typical Low $64.57 Median $190.55 Typical High $281.84 | Facility | None | $64.57 | $190.55 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $144.54 Typical High $380.19 | Professional | None | $70.79 | $144.54 | $380.19 |
Select Health Setting Facility Modifier None Typical Low $112.20 Median $194.98 Typical High $407.38 | Facility | None | $112.20 | $194.98 | $407.38 |
Select Health Setting Professional Modifier None Typical Low $51.29 Median $95.50 Typical High $194.98 | Professional | None | $51.29 | $95.50 | $194.98 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $2,754.23 | Facility | None | $758.58 | $1,513.56 | $2,754.23 |
United Setting Professional Modifier None Typical Low $72.44 Median $169.82 Typical High $346.74 | Professional | None | $72.44 | $169.82 | $346.74 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $69.18 Typical High $95.50 | Professional | 52 · Reduced service | $32.36 | $69.18 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $27.54 Typical High $38.90 | Professional | 53 · Discontinued | $12.88 | $27.54 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $104.71 Typical High $144.54 | Professional | 54 · Surgery only | $48.98 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $20.89 Typical High $28.84 | Professional | 55 · Aftercare only | $9.77 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $13.80 Typical High $19.50 | Professional | 56 · Pre-op care only | $6.46 | $13.80 | $19.50 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $91.20 Median $154.88 Typical High $257.04 | Professional | 50 · Both sides | $91.20 | $154.88 | $257.04 |
Where Colorado sits
The same service costs 3.5 times more in North Carolina than in Indiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Colorado· 43rd of 51
$132
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.